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A study to estimate the prevalence of gestational diabetes mellites in an urban block of Kashmir valley (North India)

Malik Waseem Raja, Tufeel Ahad Baba, Asif Jeelani Hanga, Safoora Bilquees, Samia Rasheed, Inaam Ul Haq, SM Saleem Khan, Anam Bashir.

Abstract
Background: The prevalence of Diabetes is increasing globally and these numbers include women with Gestational diabetes mellitus also. Based on demographic projections made by United Nations Population Division for the year 2025, WHO issued estimates of adults with diabetes in all countries and reported that there will be more women with diabetes than men and we may anticipate a considerable increase in the burden of GDM especially in less prosperous countries. ‘Gestational Diabetes Mellitus’ (GDM) is defined as any degree of glucose intolerance with onset or first recognition during pregnancy. Worldwide prevalence of GDM varies between 1.4 – 14 %. The prevalence of Gestational diabetes mellitus in India varies from 3.8 to 21% in different parts of the country, depending on the geographical locations and diagnostic methods used. Gestational diabetes mellitus has been found to be more prevalent in urban areas than in rural areas.Women diagnosed to have GDM are at increased risk of future diabetes predominantly type 2 DM as are their children.

Aims & Objective: To estimate the prevalence of Gestational Diabetes mellitus and various socio-demographic factors of the studied subjects.

Material and Methods: A Community based cross sectional study was conducted in the field practice area of Government Medical College Srinagar (Block Hazratbal: District Srinagar).The study was conducted for a period of one year from April 2011 to March 2012. All pregnant women in 24 weeks of gestation and above after undergoing preliminary clinical examination were given a 75 g oral glucose load, without taking in to consideration the time since last meal. Gestational diabetes mellitus was diagnosed if 2 hour plasma glucose was ≥140 mg/dl (DIPSI guidelines, a modified version of the WHO criterion). Tests of proportions (Chi square) and unpaired t-test were used to obtain results.

Results: A total of 306 women were registered for the study. The prevalence rate of gestational diabetes mellitus (GDM) was 7.8 % and all the cases were newly diagnosed during the study. Among various risk factors associated significantly with GDM were Gravida status, Parity and History of abortion. Overall, there was a preponderance of illiterate females (52.9%). However, the association between GDM and literacy was found to be non-significant at p > 0.05. The majority of females were home makers (96.4%) and occupation did not influence the prevalence of GDM. Majority of the studied population belonged to socioeconomic class III (Modified BG Prasad).

Conclusion: Increasing prevalence of gestational diabetes mellitus and its co-morbidities among females need immediate attention in terms of prevention and health education.

Key words: Gestational Diabetes Mellitus; Pregnant Women; Oral Glucose Tolerance Test; Prevalence; Urban Block



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